Initial Experience with 1.5‐mm<sup>2</sup> High Impedance, Steroid‐luting Pacing Electrodes

Fogel, Richard I.; Pirzada, Farouk A.; Casavant, David; Boone, John A.; Bowman, Anthony; Steinhaus, David; Gilbert, M.; Vlietstra, Ronald E.; Belott, Peter H.; Parsonnet, Victor; Tilton, Gregory; White, Melvin

doi:10.1111/j.1540-8159.1996.tb03310.x

Cited by 27 publications

(15 citation statements)

References 16 publications

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“…The increase in longevity with the CapSure Z lead as observed in the present study corresponds to recent investigations on the use of new small surface high impedance pacing leads. 6,7 Our study confirms those previous data and demonstrates the clinical relevance of those findings as it shows an enhancement in pacemaker longevity for an unselected patient population of dual and single chamber pacing including various degrees of ventricular pacing. As can be expected, the benefit of a decreased energy consumption for pacemaker longevity will be the greater the more the device is pacing the heart.…”

Section: Discussionsupporting

confidence: 90%

“…Threshold elevation in singular leads could have been a consequence of fibrotic capsule growth. 7 The sensing quality of the CapSure Z did not differ from the CapSure SP lead and allowed a save detection of R waves without problems of oversensing or undersensing. A loss of sensing was not found in any patient.…”

Section: Discussionmentioning

confidence: 97%

“…2 Initial reports on newly developed steroid-eluting leads with small surface hemispherical electrodes suggest that their electrical characteristics may provide an enhancement of pacemaker longevity without compromising system performance. [6][7][8] The impact of small surface high impedance electrodes on pacemaker longevity in comparison to leads with conventional surface size has not been proven in a prospective randomized longterm study. The purpose of this study was to describe the behavior of lead impedance and its stability in the long-term follow-up, and-determine the impact high impedance leads have on battery longevity in an unselected patient group.…”

Section: Introductionmentioning

confidence: 99%

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Extension of Generator Longevity by Use of High Impedance Ventricular Leads

Scherer

Ezziddin

Klesius

et al. 2001

Pacing Clinical Electrophis

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SCHERER, M., et al.: Extension of Generator Longevity by Use of High Impedance Ventricular Leads. The resistance of a pacing lead negatively correlates to current consumption. A prospective, randomized trial was conducted to evaluate the effect of a high impedance ventricular lead (CapSure Z) on generator longevity compared to a conventional lead (CapSure SP) eighty‐nine patients were included in the study (51 male, 37 female, age 70.0 ± 10.3 years). Forty‐six patients received a CapSure SP lead (5024 bipolar), and 43 patients received a CapSure Z lead (5034 bipolar) in a randomized fashion. Follow‐up data collected at 5 days, 3, 6, and 12 months postimplant included: lead impedance, pacing and sensing thresholds, impulse energy, and estimated time to replacement. All parameters were collected via pacemaker telemetry; the time to replacement was calculated automatically by a programmed algorithm of the pacemaker. There was no difference in the performance of the atrial lead when a dual chamber device was indicated. The CapSure Z leads displayed statistically significant higher impedance values than the CapSure SP lead in all follow‐up periods. There was no significant difference in lead related complications. No significant differences were observed between pacing and sensing thresholds in both groups. The CapSure Z leads provided a significant reduction in current drain, resulting in a reduction of mean energy consumption at the 12‐month follow‐up from 10.4 ± 5.0 μJ in the CapSure SP group to 6.6 ± 1.4 μJ in the CapSure Z group (median from 9.9 μJ to 6.9 μJ, respectively), providing an estimated increase in mean longevity of more than 1 year from 81.1 ± 23.5 months in the CapSure SP group to 94.5 ± 13.4 months in the CapSure Z group (median: 76.5 months to 95.0 months, respectively). The use of a high resistance lead for ventricular pacing appears to result in a clinically relevant extension of generator longevity.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Extension of Generator Longevity by Use of High Impedance Ventricular Leads

Scherer

Ezziddin

Klesius

et al. 2001

Pacing Clinical Electrophis

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“…In addition, pacing and sensing characteristics and lead impedance as obtained at the various septal locations in this study are similar to the values obtained with comparable lead models implanted at the RV apical position during implantation and follow-up. 38,39 Hence, RV septal pacing is feasible with the passive-fixation lead models used in this study, and it seems to be safe during long-term follow-up.…”

Section: Discussionmentioning

confidence: 86%

Septal Lead Implantation for the Reduction of Paced QRS Duration Using Passive‐Fixation Leads

Schwaab

Kindermann

Fröhlig

et al. 2001

Pacing Clinical Electrophis

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In 120 consecutive patients with standard pacing indications, we tested the feasibility of RV septal lead implantation technique guided by surface ECG and the degree to which this technique reduces paced QRS duration compared to RV apical stimulation when passive-fixation leads are used. During implantation, an ECG was recorded with a paper speed of 100 mm/s using the orthogonal Frank leads, and QRS was measured from the earliest to the latest deflection in any of the Frank leads. Pace-mapping of the septum was performed until QRS was minimal. The lead was attached, where QRS, pacing threshold, lead impedance, and EGM amplitude provided the best compromise. An average of 3.7 +/- 2.5 attempts (range 1-18, median 7) was needed until a final implantation site was found. There were no technical problems during implantation. QRS could be reduced by 5-55 ms (mean delta QRS 19 +/- 11 ms) in 83 (69%) of 120 patients. In 22 (18%) patients, QRS was identical with apical and septal pacing, and in 15 (13%) patients, QRS was 5-20 ms (10 +/- 4) longer despite septal stimulation. Average QRS was significantly shorter during septal pacing compared with apical pacing (151 +/- 20 vs 162 +/- 23 ms, P < 0.001). There was a tendency towards greatest QRS reduction when the high septum was stimulated (22 +/- 11 ms reduction) as compared with mid- (18 +/- 11 ms) or apical parts of the RV septum (16 +/- 10 ms). QRS reduction was most likely if apical QRS width was > 170 ms (P = 0.0002), and there was an inverse correlation between apical QRS and delta QRS (r = 0.53, P < 10(-7)). During a mean follow-up of 14 months, there was no pacing or sensing problem and no lead dislodgment occurred.

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“…Der theoretisch nachweisbare inverse Zusammenhang zwischen Stimulationsimpedanz und Stimulationsstrom und die damit zu erzielende Verlängerung der Funktionszeit gewinnt in der Schrittmachertherapie zunehmende klinische Bedeutung (1,10,19): Zum einen wurden speziell hochohmige Schrittmacherelektroden entwickelt (12,18), deren hohe Stimulationsimpedanz bei gleichen Stimulationsimpulsen zusätzlich den Stimulationsstrom vermindert (3,4,7). Zum anderen werden die patientenbezogenen Faktoren optimiert, z.…”

Section: Introductionunclassified

Die intraoperativ gemessene Stimulationsimpedanz von Schrittmacherelektroden ist kein Prädiktor für ihren Langzeitverlauf

Schuchert¹,

Schmidt²,

Jakob³

et al. 1998

Zeitschrift f�r Kardiologie

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Initial Experience with 1.5‐mm² High Impedance, Steroid‐luting Pacing Electrodes

Cited by 27 publications

References 16 publications

Extension of Generator Longevity by Use of High Impedance Ventricular Leads

Extension of Generator Longevity by Use of High Impedance Ventricular Leads

Septal Lead Implantation for the Reduction of Paced QRS Duration Using Passive‐Fixation Leads

Die intraoperativ gemessene Stimulationsimpedanz von Schrittmacherelektroden ist kein Prädiktor für ihren Langzeitverlauf

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Initial Experience with 1.5‐mm2 High Impedance, Steroid‐luting Pacing Electrodes

Cited by 27 publications

References 16 publications

Extension of Generator Longevity by Use of High Impedance Ventricular Leads

Extension of Generator Longevity by Use of High Impedance Ventricular Leads

Septal Lead Implantation for the Reduction of Paced QRS Duration Using Passive‐Fixation Leads

Die intraoperativ gemessene Stimulationsimpedanz von Schrittmacherelektroden ist kein Prädiktor für ihren Langzeitverlauf

Contact Info

Product

Resources

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Initial Experience with 1.5‐mm² High Impedance, Steroid‐luting Pacing Electrodes